MEDICARE: MR. PETER SOLOMON MARSHALL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	C161689	CA
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	MD426543	PA
3	207RP1001X	Pulmonary Disease Physician	MD426543	PA
4	207RP1001X	Pulmonary Disease Physician	C161689	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740252626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PETER SOLOMON MARSHALL MD

Provider Business Mailing Address
First Line	:	PO BOX 31309
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90031-0309
Country	:	US
Telephone Number	:	323-442-5100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1520 SAN PABLO ST STE 1000
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-5312
Country	:	US
Telephone Number	:	323-442-5100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	11/27/2023

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